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[e-drug] Guidelines : Anti-infectious treatment duration: The SPILF and GPIP French guidelines and recommendations

E-DRUG: Guidelines : Anti-infectious treatment duration: The SPILF and GPIP 
French guidelines and recommendations
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1. English version
1.1. Introduction
Throughout the world, antibiotic resistance has become a major cause for 
concern in public health; in this context, it is of key importance to reduce 
treatment duration in view of limiting selection pressure on bacteria.
Shortened treatment presents other advantages including lowered costs, improved 
medication compliance and reduced risk of adverse effects.

Few studies have specifically focused on treatment duration, and quite often, 
their methodology has not been robust. Treatment duration determination should 
result from prospective, comparative studies using the same molecule in two 
groups and being systematically double-blinded when the effectiveness criteria 
are far from robust (pain alleviation, reduced fever duration, tympan-related 
aspects. . .). 

Open studies are practicable in cases where the evaluation criteria are robust, 
one example being bacteriological eradication. The most sensitive points in 
these studies concern selection of relevant effectiveness criteria and 
inclusion of a number of patients sufficient to demonstrate non-inferiority 
while taking into account the proportion of spontaneous recoveries, which 
frequently occur in community-acquired infections.

The SPILF recommendation group has been mandated by the learned society to 
issue guidelines concerning the duration on antibiotic infection treatment in 
town and hospital-based practices.

Only currently existing, non-complicated infections manifesting favourable 
evolution will be taken into consideration.

On the other hand, some situations are not considered, particularly 
material-related osteo-articular infections, the reason being that a 
large-scale, randomized study comparing two treatment durations and soon to be 
published shall necessitate the updating of existing guidelines. It is for 
similar reasons that we have only rarely considered antifungal, anti-mycosis 
and anti-parasite treatments, all of which necessitate specific guidelines.

Lastly, we have not dealt with infections with regard to which, no changes have 
been noted since the publication in 2017 of an article proposing optimized 
treatment durations [1]

the article:
https://www.sciencedirect.com/science/article/pii/S2666991920000238?via%3Dihub

Carinne Bruneton 
E-MED@healthnet.org
<carinne.bruneton@hotmail.fr>

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